Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. RANDY JAMES BREEN, D.D.S.

Deactivated

This NPI has been deactivated. The record was deactivated on March 18, 2006. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number: 1003815655
Provider Type: Individual
Gender: Male
NPI Issued: Jul 17, 2005 (0.66849315068493 yrs)
Last Updated: Jul 8, 2007
Deactivated: Mar 18, 2006
License: 2901014055 (MI)

Practice Information

Address: 515 LAKESIDE DR SE

#208

GRAND RAPIDS, MI, 495062931
Browse MI providers · Browse ZIP 49506
Phone: 6164549091
Fax: 6164541159
Primary Specialty: General Dentistry
1223G0001X

Other General Dentistry Providers in GRAND RAPIDS, MI

Name	Credential	NPI
DR. MARY BERNONA STEVENS	D.D.S	1003819004
DR. PAUL J. WINN	D.D.S., P.C.	1881698140
DR. KAREN ANN O'ROURKE	DDS	1952306128
DR. GEORGE A CRIPPS	D.D.S.	1790781441
DR. GREGORY L WEAVER	DDS	1093713687
DR. MARK W TOURNELL	D.D.S.	1275520199

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.